Hospitals need a logistical control system that tracks patient throughput. By Alyn Ford, Care Logistics

s the use of dashboards continues to grow, it is time to step back and ask how they can help hospitals increase quality and lower costs. We know emergency department (ED) tracking boards have reduced the time-to-be-seen and left- without-being-seen rates, while clinical dashboards have helped clinicians with care protocols, drug administration and patient status, which improves the quality of patients’ care plans.

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But for too long, hospitals administrators have lacked the ability to capture process and cycle data, which allows for the real-time deployment of staff, full utilization of medical technology and the ability to maximize the utilization of a hospital’s limited capacity. Lean and Six Sigma teams have helped to refine process improvements and address some of the causes for the inefficiency of organizational efforts, but they do not have real-time access to process and cycle data that lies at the foundation of the issues they are asked to investigate. Frequently, the data these teams need can only be gathered from historical reports, anecdotes and statistical trending from past months and years of analytical data. What if these teams could have access to real-time process and cycle data? What if they were able to start a project by referring to exactly what is happening? What if that data was available in real time on a dashboard? Without a doubt, having this root-cause data would increase the value of their efforts many times over. The Lean and Six Sigma practices employed in many parts of healthcare have been perfected for decades in other industries, which are managed by evaluating real-time process and cycle data. In pharmaceutical production or medical device manufacturing, for example, managers know instantaneously when a key process step is falling behind the desired standard. More importantly, they are able to act on these defects immediately. Conversely, hospital care is forced to act on historical data when it comes to the process efficiency of its operational ef- forts. Average length of stay (ALOS), for example, has to be calculated from review and tabulation of historical informa- tion. This information should be represented in real time in order to predict when a patient is likely leave the hospital. There is no reason this could not be available on a dashboard.

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Hospitals should deploy a system exclusively focused on the gathering of process and cycle data in order to change ALOS in a meaningful way. In essence, hospitals need a logistical control system that tracks patient throughput. Amazon, for example, employs logistical control systems to ensure its products are efficiently delivered to customers. General Motors uses logistical control systems to manage supply chains and production lines. Airports utilize logistical control systems to manage the movement of planes to and from their facility. Hospitals, however, have not used logistical control systems to manage patient movement during their stay. Nor have they similar systems to coordinate diagnostic and therapeutic services to comply with the treatment orders physicians create for their patients.

What is needed is a system that targets the process and cycle data that can, if appropriately managed, enable front- line, physician and managerial teams to actually reduce ALOS. This is not the same dashboard created for use in ED. To be effective and valuable, the dashboard should show the time of admission, the time it takes until a bed is assigned and the time the patient is actually in the bed. What if you could, in real time, track this moment from the time the patient arrives until the patient leaves the building? These are the process- and cycle-time data points that enable hospitals to start reducing ALOS in a meaningful and sustainable way.

Dashboards are very helpful in managing many of the key facets that ensure care providers are fairly reimbursed and that the quality of patient care is sustained. But if we are really going to examine dashboards and the decision support they provide, we should be striving to capture information that provides real-time process and cycle data. This data gives our nurses, doctors, allied professionals and executive managers the ability to improve ALOS and properly schedule the optimal amount of time for patient care. The more temporal the data, the more value management

can exert, the more frequent the assessment of the data, the closer hospitals get to achieving what so many other industries have conquered: operational efficiency and top quality of services delivered.